neuro (class 9) hearing & vision loss

Question 1

hearing loss

Answer 1

50% of those over age 75.

develops due to lesions of outer ear, middle ear, or central auditory pathways.

Question 2

conductive hearing loss

Answer 2

transmission of sound is disrupted ( cerumen, edema, stenosis, tumors, perforated tympanic scarring) hearing loss across all frequencies.

Question 3

sensorineural hearing loss

Answer 3

sound waves get to the inner ear but reception/interception is decreased or distorted (commonly caused by impulse or continuous noise damage to hair and cells and organ of corti = high frequency hearing loss_

Question 4

presbycusis

Answer 4

aging related degeneration of cochlear hair cells, gradual hearing loss progressing across adulthood.

Question 5

cues to hearing loss

Answer 5

increased voice volume.
head position with good ear toward speaker.
ask for repetition.
respond inapppropriately to conversation
can appear confused
decreased socialization
difficulty in groups.

Question 6

audiometry

Answer 6

diagnose conductive & sensorineural hearing loss.
pt sits in soundproof room & responds to sounds when heard.
identifies type and pattern of hearing loss.

Question 7

hearing aidsy

Answer 7

amplify sounds, doesnt correct or treat problem.

challenges: denial, vision problems, manual dexterity, cost.
types: in-canal, in the ear, and behind the ear.

Question 8

conductive surgery

Answer 8

reconstruction

Question 9

sensorineural surgery

Answer 9

cochlear imlants.

Question 10

vertigo

Answer 10

sensation of movement when there is none.

symptom caused by various problems-often RT inner ear.

Question 11

vertigo assessment:

Answer 11

is the world spinning or are you light-headed?
is it related to movement?
are you having problems with your balance?
are you experiencing nausea and vomiting?
how long does the sensation last?
ringing in your ers?
autonomic symptoms(sweating, hypotension, salivation, pallor)?

Question 12

vertigo interventions

Answer 12

gradual position changes

turn whole body
sit down immediately
medication.

Question 13

Menieres disease

Answer 13

cause: unknown, but accumulation of excessive fluid in the membranous labyrinth occurs.
symptoms: vertigo, tinnitus, progressive hearing loss.
diagnosis: hx & PE, audiometry, vestibular testing, glycerol test (osmotic effects pulls some of excess fluid)

Question 14

Menieres disease treatment

Answer 14

symptomatic management & diet: no ETOH, caffeine, low sodium.

meds: diuretics, motion sickness meds (meclizine), nausea meds.

Question 15

macular degeneration

Answer 15

damage to the retina (macula provides focus/central vision)
dry (nonexudative), accumulation of drusen deposits, nutrition slows progress-vitamins, lutein, betacarotene.
wet: develops from progression of dry, leakage from waek blood vessels, scarring.

treatment: injections that prevent new vessel growth, laser.
risk: age, caucasion, smoking.

Question 16

cataracts

Answer 16

opacifacion of the lens due to clumping of protein that blocks light and blurs vision.

common > 50% of those over 80.

risk: age, sunlight, smoking, trauma, DM, steroids.
surgery: surgical removal of lens & replacement intraocular lens implanted. outpatient surgery. eye drops per&post op.

Question 17

glaucoma

Answer 17

damage to optic nerve from increased intraocular pressure
loss of peripheral vision
open angle glaucoma-most common, gradual impaired drainage thru trabecular meshwork, painless; both eyes.

closed angle- rapid or gradual onset, systemic s/s with exac: HA, N/V, pain, blurred vision, halos, one eye, pupil may be fixed.

meds: beta blockers, prostaglandins, carbonic anhydrase inhibitors.

surgery laser holes into trabecular network, fistula or tubes for drainage.

Question 18

retinal tears and detachment

Answer 18

separation of the retina or sensory portion of the eye from the choroid, the pigmented vascular layer.

usually spontaneous, but can be caused by trauma.

medical emergency.

s/s: floaters, flashes of light, blurred/curtained vision, painless.

positioning so gravity pulls retina into contact with choroid.

surgery for tears: cryotherapy or laser to weld layers back together.

surgery for detachment: pneumatic retinopexy (use air/gas bubble) to pressure area back against the wall, scleral buckle or vitrectomy.